Houston dentist, Behzad Nazari, and Antoine Dental to remain on 100% “pay hold” due to fraud investigation

UDATED 03-03-2014

The scammers running the Texas Dentists for Medicaid Fraud Reform (TDMR) website have boasted time and time again, over rulings made against Texas taxpayers and for Antoine Dental. Heck, they have a whole section of their website devoted to their “wins”. They have also had their cronies on this website, commenting about how they are winning their cause; which appears to be “Let us continue to defraud taxpayers.” Frankly, I think their name should be “Friends of Dental Medicaid Fraud”. I’m not sure what they consider a “win”. Apparently, it’s not what you and I call a “win”. Their headlines over there are outright false! So imagine the bullshit contained within! I especially love their comment section, entitled “Speak Your Mind”, amazingly what is on my mind doesn’t seem to make it, maybe yours will. Click here.

Examples:
On November 5, 2013 their headline read, “OIG Loses Another Medicaid Fraud Court Battle” an article they were happy to assist with in the Texas Tribune.

(Battle, yes, WAR, NO!)

Then on November 6, 2013 their headline read – Antoine Dental Center Innocent of All OIG Allegations of Fraud and Misrepresentation.

(This is especially galling, since it is an outright lie! Lie!!! Lie!!)

Again, on January 17, 2014—SOAH Judges Again Reject OIG Arguments in Antoine Dental Case

(Laughable!)

Today, what’s missing from their website is the headline of this blog post;or something close to it.

It appears the Applet Court and Judge Rick Gilpin disagreed 100% with all other rulings in the Antoine defraud Texas taxpayers case. He issued a “Final Order” on Friday (February 28,2014) that walked through this case and all the hearings and ruling step by step and ruled completely opposite of all other rulings—Antoine Dental to remain on 100% pay hold.

You don’t want to miss reading the Final Order. He all but called them all, Antoine owner, Dr. Nazari—including the Administrative Law Judges—criminals and at the best—imbeciles. You read it and decide.

Dr. Daniel Chaparro III, owner of Smile By Design, under investigation by FBI

I found Dr. Chaparro’s concerns over his investigation by the FBI a bit odd.

Apparently, he has enough wrong doings on the radar of authorities to result in a raid by the FBI. Yet, his concerns seems to me a bit misplaced, but I could be wrong.

The icing on my cupcake was his apparent frustration of having to deal with the government’s “spider webs of government red tape”  He seems to think he was forced to see Medicaid patients.I doubt he was grumbling when he was receiving taxpayer monies for those services.

Looking at the 2011 data made available by the 2012 Kool Smiles funded Art Laffer DSO Study, Smiles By Design was way down on the list of outrageous billers in Texas.

However, Chaparro has been in trouble before.

See: http://cqrcengage.com/capg/app/document/1697422;jsessionid=klTJmUc7gY-oFKgGZsWXQeAF.undefined

"Chaparro has faced criminal charges in the past including aggravated and domestic assaults between 1995 and 2000, practicing dentistry without a license in 2003 and injury to a child in 2004. He was convicted of domestic assault in 2002, according to court records."

He was also disciplined by TSBDE in 2000 & 2006.

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Lubbock dentist warns of 'Big Brother' as FBI investigates Medicaid billing

Posted: Feb 20, 2014 12:03 PM CST Updated: Feb 20, 2014 10:45 PM CST

By Shaley Sanders - bio | email

LUBBOCK, TX (KCBD) -

A Lubbock dentist is voicing concerns about patient privacy and complaining about "Big Brother" after the FBI seized his patient records on Thursday morning.

The FBI executed multiple search warrant around 8 a.m. Thursday at the home of local dentist, Dr. Daniel Chaparro III and at his business, Smile by Design.

"They didn't need a warrant, they could come ask for anything they wanted and the record room is always open to them. I don't know why they escalated this to a drama, basically," Chaparro said.

Dr. Donald P. Prohovich pays $400,000 to settle fraud allegations in Massachusetts

 

 

 

By Maria Papadopoulos
The Enterprise
Posted Feb. 25, 2014 @ 12:39 pm
Updated Feb 25, 2014 at 6:17 PM

An Easton dentist has agreed to pay $400,000 to the state’s Medicaid program to resolve allegations of improperly billing for visits to MassHealth members living in nursing homes, Attorney General Martha Coakley announced Tuesday.

An investigation found that Dr. Donald P. Prohovich, a dental provider in the MassHealth program, violated a regulation established in 2010 that limits payments for providers to one “house call” to a facility per day, Coakley said in a statement.

Investigators found that from July 2010 to September 2013, Prohovich allegedly improperly billed for house calls to elderly MassHealth patients in nursing homes in eastern Massachusetts on a per-patient, per-day basis.

UPS Employees targeted by California dentist

Calif. dentist indicted for $1M in fraudulent billings

By DrBicuspid Staff

February 25, 2014 -- A California dentist has been indicted on federal healthcare and mail fraud charges of billing more than $1 million for work never performed, sometimes for teeth patients didn't even have.

According to the U.S. attorney's office, Sacramento dentist David M. Lewis, DDS, 60, began targeting United Parcel Service (UPS) employees in 2008 for dental treatment. The UPS healthcare plan provided 100% coverage with no annual limits. Dr. Lewis offered cash and other incentives to UPS patients for getting dental care from him or for recruiting other UPS employees to receive treatment.

The grand jury's 18-count indictment alleges that Dr. Lewis submitted claims to Delta Health Systems, which administered the UPS healthcare plan, and falsely billed the plan for work that was never performed. In many instances,

READ THE COMPLETE STORY HERE

Dr. David Timothy “Ty” Turbyfill, accused of sexually molesting 3 teens is back in business in Florida.

Dr. David Timore Turbyfill, accused of sexually molesting 3 teens is back in business in Florida. Among claims in the complaints, witnesses alleged that Turbyfill was “seen moving his hips and pelvic region suggestively near patients and seemed to be sexually aroused in the presence of some patients — covering his groin and leaving the room on more than one occasion.”

I guess it’s possible he was just “twerking”. (sarcasm)

Blessed by the Florida Board of Dentistry, he now has access to patients at Orange City Surgical Solutions
2574 S. Volusia Ave.
Orange City, FL 32763
386-744-2999
info@orangecitysurgicalsolutions.com

It’s also noted he has dropped the “Ty” nickname and using his real name, David Tim (Timore) Turbyfill.

His bio at the website lists numerous titles and awards, but fails to include any mention of the accusations and settlement.

According to his settlement agreement,Turbyfill is required to be “monitored” by a “licensed health professional” when using anesthesia or conscious sedation. I wonder exactly who is doing that “monitoring” and how the “monitoring” is being “monitored”.

Flora Mounessa, DDS and husband—Shahram Sharif—arrested

Flora Mounessa,DDS husband, Shahram Sharif then and now.

According to Great Neck, NY District Attorney, the couple defrauded Medicaid out of $70,000, but this couple did it with a “twist”, not seen much here on DTM.

This couple underreported income and assets to obtain benefits. Dr. Flora must not be well schooled on the proper defrauding of Medicaid by dentists or this is the new “bonus” system.

According to reports, the couple actually had income of $2.74 million during the 5 year period. Just looking at the numbers it might look like they left out some zeros on their reports. I don’t know, and this is just a guess, but I bet there was some other Medicaid defrauding going on over at the dental clinic. Take a look at the “store front”, looks more like a pawn shop to me.

Greed may be good, as pointed out in the movie “Wall Street”, but it sure isn’t good for one’s looks,is it? “Road hard and put away wet” is what comes to my mind when checking out the mug shots.

 

 

 

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A husband and wife face felony fraud charges after underreporting assets and raking in more than $70,000 in Medicaid benefits, according to the Nassau County District Attorney's office.

Flora Mounessa, 39, and Shahram Sharif, 45, both of Great Neck, were each charged with one count of second-degree welfare fraud, one count of second-degree grand larceny, and one count of first-degree offering of a false instrument for filing.

The couple is accused of underreporting their assets enough to be able to claim Medicaid benefits for themselves and their daughter. They allegedly reported an annual income between $23,400 and $31,200. 

Between January 2005 and October 2010, the defendants received $70,193.64 in benefits. During that time, Mounessa worked as a dentist and Sharif was self-employed, buying and selling real estate. Their jobs raked in $2.74 million over the five years they were given benefits.

The couple was arrested and charged Friday after an investigation.

If convicted, the couple faces possible 15 years in prison, plus restitution and fines. The smallest consequence they could face is a conditional discharge, said the DA.

They were released by a judge and put on probation until they return to court March 11.

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Dr. Flora Mounessa’s facebook pages says she works for Nora Family Dental, studied at NYU and prior studied at Yeshiva University (SCW)

Interview with Dr. Mark Malterud — Academy of General Dentistry Region-10 Trustee

 

Interview with Dr. Mark Malterud

By Michael W. Davis, DDS | February 17, 2014

 

 

Dr. Mark Malterud has been practicing Minimally Invasive Restorative Dentistry for over 30 years in St Paul Minnesota. He has had the opportunity to help many patients achieve excellent oral health. His passion for Dentistry has led him into involvement into Organized Dentistry where he has been Minnesota’s President of the Academy of General Dentistry and has chaired at the National level, the AGD’s Council on Dental Education and is the current Region-10 AGD Board of Trustees member. He helped get the Academy of Biomimetic Dentistry up and running and sits on the Board of the World Congress of Minimally Invasive Dentistry. As a consummate student and innovator in Dentistry he has been invited and presented lectures around North America and the World. Mark@drmalterud.com

 

INTRODUCTION

Dr. Davis: Dr. Malterud, I’m honored to bring forth this interview. You’ve done a great deal facilitating education for the dental profession, which eventually serves the public interest. Services dentistry can provide patients today is greatly advanced, from 10-20 years ago. You have personally contributed to this wonderful progress, some of which I hope to expand upon with our discussion.

 

INTERVIEW

Dr. Davis: The dental profession today is exposed to newer concepts, such as “minimally invasive dentistry”. Over time, these principles are becoming accepted into dental university curriculums and the general practice of dentistry. Please explain to the average person, what is meant by minimally invasive dentistry and how it may benefit them. Please give a few specific examples, in our rethinking of traditional treatment protocols.

Dr. Malterud: I appreciate being asked to be interviewed for this column. As far as the meaning of Minimally Invasive Dentistry (MID), I can sum it up fairly easily. It is a philosophy that tooth structure is sacred and once removed it cannot be brought back. So, treat every lesion and problem from the perspective that we remove the problem (pathology) and restore it as definitively as we can with modern technology.

The reality is that whatever we place in the mouth to restore what has been lost will break down, and, in time, given enough use, will fail. However, technology, materials and techniques are constantly being developed, and, when the time comes for restorations to be replaced, we will have better materials to restore the tooth. I heard it once described as tooth banking by Dr. Ray Bertolotti and that is a good description.

Kool Smiles Dentist—Dr. Tuan “Terry” Truong, DDS— sentenced to 18 months in jail

Let me get this straight, private equity firm FFL’s corporation—NCDR, LLC/Kool Smiles—hired Dr. Troung, trained him to be a thief, gave him quota’s to meet, and now want their money back for legal expenses. OMG!

Here is what I want to know:

1. Why was Dr. Tuan Truong not on his hands and knees begging to spill his guts about this crooked company?

2. If he did who stopped him and why?

3. Was he here on a work visa?

PS: Don’t choke and puke when you read out “Kool Smiles” cooperated with the investigation! You bet your ass they did, and directed investigators to only what they wanted them to know apparently.

 

Abilene Dentist Sentenced to 18 Months in Federal Prison and Ordered to Pay Nearly $58,000 in Restitution in Medicaid Fraud Scheme

FOR IMMEDIATE RELEASE

February 5, 2014

Defendant Worked as a Pediatric Dental Provider at Kool Smiles
and Personally Benefitted From Scheme

ABILENE, Texas — Dr. Tuan Truong, aka “Terry Truong,” of Abilene, a dentist who practiced pediatric dentistry at Kool Smiles in Abilene, was sentenced this afternoon, by U.S. District Judge Jorge A. Solis, to 18 months in federal prison.  Truong pleaded guilty in August 2013 to an Information charging one count of making a false statement in connection with a health care matter.  Truong was also ordered to pay $57,969 in restitution to Kool Smiles.  Today’s announcement was made by U.S. Attorney Sarah R. Saldaña of the Northern District of Texas.

According to documents filed in the case, in summer 2008, Truong began working for Kool Smiles, which paid him a base salary and offered opportunities for bonuses based on additional procedures he performed in excess of daily targets set by Kool Smiles management.  Dentists were required to use professional judgment in the treatment and management of patient care.

Uh-Oh! Dr. Richard Malouf abandoned his computer servers! YIKES!

Dr. Richard Malouf, founder of All Smiles Dental Centers in Texas, has made the news a lot over the last two years. Much of which has involved charges of Medicaid Fraud, indications of bribery, and his infamous home water park in an affluent neighborhood of Dallas and 2 private jets.

 

 

 

 

Last week, (January 31, 2014) Dr. Malouf was back in court, this time in front of the bankruptcy judge. Under an earlier Agreed Order (Doc 637) Malouf agreed to abandon the property to the state, with the “provision that a neutral third party” would serve as Special Master of the bankruptcy estate.

Apparently Malouf was more concerned about the proper functioning of his waterpark than what incriminating evidence might be on the computer servers he happily “abandon” to the state of Texas. He recently tried to block the State of Texas access, but in an Order issued January 31, 2014 (Doc 762) a judge “clarified” the previous Agreed Order telling Malouf, tough titty.

Ok, so the judge didn’t say exactly that but did say:

“To avoid further doubt, the Court further clarified that the property was abandoned with this Court’s approval to The State Of Texas and simply appointed the Special Master to provide fair access and control, but not as owner of the property.”

“It was the Debtor’s prerogative to decide what to do with the property. The Debtor decided and this Court approved abandonment. The Malouf entities agreed to the abandonment.”

I bet you don’t see this over on the TDMR website!

NCDR, LLC–Kool Smiles-Resolution Dental wants you and your practice.

The private equity firm, FFL, who owns Kool Smiles Dental and Resolution Dental is moving away from opening their own clinics and moving toward the Heartland Dental business model—what I call the F & S business model. (S for suck, so you can figure out what the F stands for). 

F & S Business Model - This is where they come in, offer practice owners an unrealistic amount for their established practice, put the current owner and staff under employment contracts, then set unrealistic income quota’s that forces dentists and staff to make decisions not necessarily good for the patient. See A peek under the sheets of Heartland Dental

Rumors last years indicated Kool Smiles Dental had their highly questionable but lucrative Medicaid income stream reduced significantly due to what was apparently questionable dental treatment and billing practices. In 2013 they began switching many of their practices to Resolution Dental.

Now, they want to purchase already established dental centers. I’m sure this is a much faster way to increase the dwindling revenues.

They advertise:

Are you considering selling your practice? Let's talk.

They want locations “not in the hood” and are offering a “fast and furious” “too good to be true” amount cash for said locations. They want dentists willing to sign restrictive 2 years employment contracts, which will no doubt include a stiff penalties, especially for disparagement of the company. They also offer bribe your staff to stay on, but make no promises.